Kidney Life Spring 2024 by National Kidney Federation

KIDNEYLIFE SPRING 2024 ISSUE

The magazine of the National Kidney Federation

Rest in peace Sir Roy Calne The pioneering British surgeon renowned for conducting the world’s first liver, heart and lung transplant, has passed away at the age of 93

Charity Nos. 1106735 SC049431

News

Your Stories

Fundraising

The Impact of the NKF Home Dialysis Peer Support Service

A Three Way Match

NKF Draw / Special Events

Page 05

Page 08

Page 20

Editor’s Note

Welcome to the first issue of Kidney Life for 2024 As we move into February and the daylight lasts a little longer, we look forward to the spring and a little warmth and sunshine. We have the NKF Kidney Patient Association (KPA) Day coming up in April and I look forward to seeing all of the KPA representatives there, details can be found on page four. We are just completing the finer details with regards to the NKF Annual Patients’ Event which will take place in the Autumn, we will provide details in the next issue. We have been continuing our campaign to increase home dialysis and we look forward to sharing the updates with you all when we release the next report in April. In this issue we have some powerful patient stories. Stephanie Digance, page eight, shares her journey from diagnosis to receiving a transplant from her uncle, despite the obstacles she has faced she remains thankful and reflects on the strength and optimism in what she does have. Kay Allardyce, page 12, returns with an extract from her published memoir, ‘Thanks for My Kidney, Mum!’ Sharing with us in this issue her personal experiences with anaemia and EPO injections.

In this ISSUE... YOUR STORIES

08 A Three Way Match 12 Anaemia and EPO 16 The Greatest Gift 18 Finding a Kidney Donor and Friend

NEWS

03 NKF Dates of the Year 04 NKF KPA Day 05 Home Dialysis Impact 06 Kidney Beam 07 Sir Roy Calne 14 NKF Helpline information leaflets

FUNDRAISING

20 Christmas Draw Winners/Fundraising Events for 2024

PUZZLES

22 Word Search

NKF OFFICERS Chairman – David Coyle Co Vice Chair – Caryl Bryant Co Vice Chair – Tarsem Paul Treasurer – Mike Sinfield

Jane Colebrook shares her story of hope, resilience and the power of a second chance on page 16.

Secretary – Brian Child

Chetan Joshi, page 18, pens his profound story on how he discovered he had early stage renal failure, whilst also dealing with the after effects of a debilitating stroke, life on dialysis and an unexpected call that changed his life leading him to meet his donor and now great friend, Jean.

NKF TEAM

We also explore the many different blood pressure tablets that are available to bring your blood pressure down and what the NKF Helpline information leaflets cover to help provide guidance in times of need. Please get in touch if you’d like to share your story with us, we can help you write it and send us any feedback you have on this issue by emailing kidneylife@kidney.org.uk.

Andrea Brown – Chief Executive Pete Revell – Head of Marketing & Fundraising Donna Blizard – Office Manager Sharney Warren – Communications and Marketing Officer and Temporary Contributing Editor of Kidney Life Fiona Broomhead – Senior Office Administrator Heather Mooney – Accounts Administrator Linda Pickering – Helpline Advisor Stephen Emmerson – Helpline Advisor and Peer Support Coordinator

Best Wishes Andrea Brown NKF Chief Executive

Registered Office: The Point, Coach Road, Shireoaks, Worksop, Nottinghamshire S81 8BW T: 01909 544999 E: nkf@kidney.org.uk

EVENTS SCHEDULE 2024

16TH MARCH

KDARS FOR KIDS: BRAVE BEAN AWARDS Radisson Blu Hotel, East Midlands Airport, DE74 2TZ

KIDNEY PATIENT ASSOCIATION DAY (KPA DAY)

13TH APRIL

Arden Hotel, Birmingham, B92 0EH

11TH - 13TH JUNE

UK KIDNEY WEEK

Edinburgh International Conference Centre, EH3 8EE

NKF ANNUAL PATIENTS’ EVENT

TBC

Date and location to be confirmed soon.

MORE INFO:

WWW.KIDNEY.ORG.UK

News & Events

Saturday 13th April

KPA Day 2024 Arden Hotel, Birmingham Saturday 13th April – 10am – 4pm

Registration is now open

We are pleased to announce that registration is now open for this year’s Kidney Patients’ Association Day. The day is a great networking event to meet and share successes with other like minded KPA’s. The event will also involve the NKF Annual General Meeting where the new NKF Executive Committee will be elected and the Council meeting will be held at the end of the day. Completed nomination forms to apply to be a member of the NKF Executive Committee must be received by the NKF office by 1st March 2024. If anyone would like more information about the day or about becoming an NKF Executive Member, please call 01909 544999 or email nkf@kidney.org.uk.

KPA DAY 2024 PROGRAMME 10.00 – 10.30 Registration and coffee

12.10 – 13.00

10.30 – 10.40

13.00 – 14.00 Lunch

Welcome and launch of the 2024 Increasing Home Dialysis Report – David Coyle, Chair NKF

10.40 – 11.40

Break out group discussions, KPA’s sharing best practice

11.40 – 12.10

Coffee break and networking

Feedback from group discussions

14.00 – 14.45

NKF AGM

14.45 – 15.00

Coffee break

15.00 – 15.30

Council meeting

15.30– 16.00

Open Forum and Close

Everyone attending must call or email to register for the event which is free to attend. Lunch and refreshments will be provided. Please note that the KPA Day is only for KPA members and NKF friends.

All Party Parliamentary Kidney Group Update

The All Party Parliamentary Kidney Group (APPKG) AGM was held on 17th January 2024. The elected officers are: ROLE

NAME

PARTY

CONSTITUENCY

Chair

Khalid Mahmood MP

Labour

Birmingham, Perry Barr

Vice Chair

Gavin Newlands MP

SNP

Paisley and Renfrewshire North

Vice Chair

Julie Elliott MP

Labour

Sunderland Central

Officer

Andrew Lewer MP

Conservative

Northampton South

Secretariat

Andrea Brown

CE of NKF

For more information about the APPKG please visit: 4 |www.kidney.org.uk/all-party-parliamentary-group Spring 2024 | www.kidney.org.uk | HELPLINE 0800 169 0936

Spring 2024 Home Dialysis Impact

The Impact of the NKF Home Dialysis Peer Support Service The National Kidney Federation's Home Dialysis Peer Support Service has been providing valuable assistance to those living with kidney disease for over two years now. In this issue, we take a moment to reflect on the impact of the national service and hear directly from the peer supporters who have been a lifeline to so many. Join us as we explore the impact of the NKF's Home Dialysis Peer Support Service and why the service is a vital resource. "Being a Peer Supporter is not ‘easy’ but it is rewarding…

One caller, Asif, who has benefited from the service shares,

My name is Patricia, and I am a Home Dialysis Peer Supporter for the National Kidney Federation. I made a pledge many years ago, that I will never knowingly allow another kidney patient to go through what I went through when I was diagnosed with Chronic Kidney Disease. There was hardly any education on kidney failure or dialysis and at times I was given the wrong information! My mantra is ‘no one knows a kidney patient like a kidney patient’. I understand what you are going through, I have been through dialysis, I have had the doubts… the worry… the fear. I do what I do to take away some of the anxieties you may have in the early stages of your diagnosis. Please use our Home Dialysis Peer Support Service, we are here for you!"

"I didn’t realise how involving and depressing peritoneal dialysis at home would be.

Patricia Gooden (MCCT) "Becoming a Peer Supporter for the NKF was, I thought, going to be a relatively straight forward question and answer service. I soon discovered that the questions asked were as interesting and as variable as we are ourselves… Every one of us are different and an answer to a question is not as straightforward as I supposed. Treatment that worked well for me may not be as suitable for someone else and so I had to take into account the lifestyle of my fellow kidney patient and discuss the pros and cons with him/her to help them to come to a decision which was right for them. Some kidney patients are obviously very worried about beginning dialysis treatment, and I am never happier than when I am thanked for discussing their worries with them and helping them to understand that it is possible to cope with dialysis and, indeed, to take control of their treatment instead of it controlling them." Jeff Wood

One moment I was fit, healthy and managing my kidney disease. The next my kidneys failed, I needed surgery to fit the catheter tube, began training to use the dialysis machine, all whilst overseeing a home renovation project which now needed to be completed in time so I could begin treatment at home. The hospital gave instructional guidance, but no practical advice of how to adjust my life or any emotional support. I found dialysing painful, isolating, and questioned how long I could do this for. Thankfully I contacted the National Kidney Federation and they matched me with someone who could relate to my experience, answer practical questions and advise on relevant support services. My peer supporter was someone who listened to my feelings and put my mind at ease. I can’t describe how grateful I was for this, as it was a time when I lost hope and didn’t know where to turn. Thank you NKF for finding me Patricia.” The NKF National Home Dialysis Peer Support service is recognised as a designated provision by Diaverum and Fresenius Medical Care.

Thank you to Baxter Healthcare Ltd for helping to financially support this service.

For more details contact the NKF Freephone Helpline on

0800 169 09 36

HELPLINE 0800 169 0936 | www.kidney.org.uk | Spring 2024 | 5

News & Events

Beaming with Support: Kidney Beam Now Free in All Eight Kidney Networks Across England Kidney patients in the South of England can now access Kidney Beam, a free online wellbeing platform. The National Kidney Federation coordinated with Southern Kidney Patient Associations to secure funding for the platform in their region, enabling Kidney Beam to become fully funded in all of England. Kidney Beam is an online platform that hosts live and ondemand exercise, education and well-being classes aimed at anyone over the age of 16, with any ability, any kidney condition and at any stage of kidney disease. The platform aims to help those living with kidney disease manage their condition and improve their quality of life. Thanks to the NKF's funding and the generosity of Kidney Patient Associations, including Wessex KPA, Sussex KPA, Bristol KPA, Exeter KPA, and Gloucester KPA, all kidney patients in England can now access the platform's features. Dr Sharlene Greenwood, Consultant Physiotherapist at King’s College Hospital, Co-Founder and Chief Medical Officer, Kidney Beam and Past President of the UK Kidney Association said: “We are delighted that the National Kidney Federation and the Kidney Patient Associations in the South West and South East have pledged funding to give free access to Kidney Beam for all people living with kidney disease in these regions of England. This now means that together with Renal Network funding in other regions, Kidney Beam is being provided across all of England to support and

6 | Spring 2024 | www.kidney.org.uk | HELPLINE 0800 169 0936

encourage kidney patients in taking care of their physical and mental health. We believe this is an important endorsement of the platform by people living with the condition as well as healthcare providers, all of whom see Kidney Beam as a tangible way to redress health inequalities by providing routine access to kidney-specific physical rehabilitation at scale.” Andrea Brown, National Kidney Federation Chief Executive commented: "We are thrilled to see Kidney Beam expand their support free of charge to all of England, the platform is a vital resource to support kidney patients in managing their physical and mental health. I would like to say a big thank you to the Kidney Patient Associations in the South East and South West that have made this expansion finally happen alongside the National Kidney Federation’s support. We strongly encourage patients to take advantage of the live and on-demand fitness classes, education and wellbeing platform, and utilise the motivational support that Kidney Beam provides."

For more information on Kidney Beam visit: www.kidney.org.uk/ kidney-beam

Spring 2024

In Memoriam:

Sir Roy Calne (1930-2024) Sir Roy Calne, the pioneering British surgeon renowned for conducting the world's first liver, heart and lung transplant, has passed away at the age of 93. Sir Roy Calne's ground-breaking journey into transplantation began in the 1960s when he, a Professor of Surgery at Cambridge University, delved into finding solutions for individuals grappling with kidney and liver failure. Key Achievements of Sir Roy Calne: • Completed the first liver transplant in Europe in 1968 • Accomplished the world's inaugural liver, heart, and lung transplant in 1986 (collaborating with John Wallwork) • Achieved the world's first successful 'organ cluster' transplant (involving the stomach, intestine, pancreas, liver, and kidney) in 1994 • Among Calne's significant contributions was his pioneering use of drugs, including Cyclosporine, an immune system-suppressing drug crucial for preventing organ rejection. This breakthrough revolutionised transplant medicine, garnering widespread acceptance and significantly increasing the number of transplant units globally. By 1977, Cyclosporine had elevated the chance of survival one year post kidney transplant to approximately 80% Inspired by the plight of a young patient facing kidney failure, during his medical studies in the 1950s, Calne embarked on a mission to find innovative ways to save lives through transplantation. His journey led him to Oxford University and later the Royal Free Hospital in London, where he began experimenting with kidney transplants in animals. His dedication to finding successful transplantation methods eventually led to the use of Azathioprine, an immunosuppressant, and other groundbreaking drugs. Calne's remarkable career unfolded with various appointments, including Anatomy Demonstrator at Oxford University, a Harkness fellowship in Boston, and later, Professor of Surgery at Cambridge. His tenure at St Mary's Hospital marked a turning point when prompted by patient deaths post-kidney transplants, he advocated for the use of Azathioprine to improve outcomes. In 1968, Calne performed the first liver transplant in Europe, marking a historic milestone. His partnership with Hepatologist Roger Williams in the 1970s further advanced liver transplant techniques. However, the pinnacle of his achievements came with the introduction of Cyclosporine in 1977, significantly improving post-transplant survival rates.

Over the years, Calne's transplant program flourished, conducting over 100 liver and 80 kidney transplants annually by the 1990s. His team pioneered the use of various immunosuppressant drugs, contributing to the field's advancement. Calne's legacy extended to his service in Singapore as a professor of surgery following his retirement from the NHS. Sir Roy Calne, born in Richmond, Surrey, received numerous accolades, including election as Fellow of the Royal Society (1974), knighthood for services to transplant medicine (1986), and the Pride of Britain Lifetime Achievement Award (2014). In reflecting on his remarkable career, Sir Roy Calne's contributions to the field of transplantation continue to reverberate, leaving an indelible mark on medical history. Peter Constable, a trustee of the NKF, was Chair of Addenbrooke's Kidney Patients Association when he first met Sir Roy Calne. “I was very sad to hear that Professor Sir Roy Calne died on 6th January 2024, just days after his 93rd birthday. Although he spent from 1965 to 1998 as Professor of Surgery at Cambridge University and a Consultant at Addenbrooke's Hospital, his circle of friends and colleagues ranged far and wide. As did his medical appointments, from the Royal Free to Boston USA to Singapore, during his search to prevent transplant rejection. HE SHOWED IT COULD BE DONE using Cyclosporine which is still used today. Countless people owe their lives to his persistence. His legacy is to all people of the world. Lesser known were his talents as an artist and sculptor which brightened the corridors of Addenbrooke's. His sculpture 'Tribute to the Organ Donor' demonstrates his wider appreciation of the essential need for the involvement of others. Sir Roy was very much a family man, he and his wife Lady Patsy regularly attended Addenbrooke’s Kidney Patients Association annual carol service, meeting old and new friends. Deepest condolences to Patsy and the family.” Peter Constable Trustee of the NKF Executive Committee

HELPLINE 0800 169 0936 | www.kidney.org.uk | Spring 2024 | 7

News & Events Your Stories

A Three Way Match:

Stephanie Digance’s Story Stephanie Digance, a woman diagnosed with Chronic Kidney Disease, shares her journey from diagnosis to receiving a transplant. Despite the setbacks she has faced, she remains optimistic and thankful. I'm Stephanie Digance and I was diagnosed with Chronic Kidney Disease in 2005, after my pregnancy flared some issues. They initially thought it was pre-eclampsia, but a biopsy showed it was IGM Nephropathy and Mesangial Proliferative Glomerulonephritis. Despite having no symptoms, I saw my nephrologist yearly and my outlook looked promising. In 2015, I noticed my kidney function was declining, but slowly. Despite undergoing several treatments, my condition persisted. I came to terms with the possibility of needing a kidney transplant. However, I remained optimistic and focused on the positive aspects of my life, including my family and my ability to cope with the situation. In 2021, we explored dialysis and transplant options. In December 2022, I caught COVID, felt fine by Boxing Day and tested negative, but then my health deteriorated. I called 111 on 30th December, was prescribed painkillers and told to have my bloods checked the following day. However, a call was later returned and I was told to pack a bag and wait for an ambulance. Tests showed I was at EGFR 3 and my creatinine was in the 1000's, I was put in ICU and placed on hemofiltration for 3 days. A PCR tested positive for COVID and I had picked up another infection that they couldn't locate, I tested positive for COVID for 2 weeks after that, even though I originally tested positive on 21st December. After 12 days in the hospital, I returned home. I worked part-time and increased my hours as I regained my strength. However, my daughter was worried about my health and put out an appeal in the paper for donors. I was mortified but knew her motivation for doing it and that it was out of love. I lost my mum at 27 (my mum 8 | Spring 2024 | www.kidney.org.uk | HELPLINE 0800 169 0936

was 47) and she did not want that pain. Lots of generous people called, some went further for blood tests and some lovely friends and family did also. Considering I have the most common blood type, we were not finding a match. My daughter was amongst those who tested. I was quietly pleased that she wasn't a match, but then she chose to join the pairing scheme. A year of lots of tests and travelling, we made the list. At the same time, my uncle, my mum's brother was on the same journey as my daughter. My uncle had also received the green light for the pairing scheme. In July, I received the call that there was a three-way match, it was with my uncle! A few more tests followed and a meeting and then a date was set. My uncle had given up some pleasures in life to be able to do this and showed so much courage. I joked he had a little motivation because my mum would've had 'stern words' (in a polite way) she would've been very proud. My uncle has always been a generous soul and one of the best uncles. I sat the morning of my operation tearfully writing my donor a letter of thanks. There were six in the scheme, 3 donors and 3 receivers. I was in Portsmouth and my uncle in Scotland. Both surgeries were a success. My uncle had healed well and was released in 4 days. Sadly, my numbers started to rise. The hospital wanted to start treating rejection before they had the test results back. A CT scan followed after my numbers started to rise. Photo taken when the neck line went in and Stephanie was on the total plasma exchange and on high dose steroids

Spring 2024 I had a neck line put in, an antibody test and a biopsy. I then started Therapeutic Plasma Exchange (TPE). An antibody test came back negative. My biopsy however showed rejection, both kinds! I had cellular rejection and anti-body rejection. 5 days of plasma exchange was then completed, I started Anti-Thymocyte Globulin (ATG), something to do with putting cells derived from rabbits in me. Isn't the medical field a marvellous place! Of course, I had to be given antihistamines and have an anaphylaxis kit on standby. 2 x 12 hours infusion, I felt fine, really ok in fact. My numbers were all coming down, not as quick as they'd like but coming down was good. I then had a two-day break, 3x 8 hr infusions which knocked me for six, and I suffered terribly with what they call serum sickness and could barely move my body. My haemoglobin was under 80, my platelets under 100 so I ended up having 4 blood transfusions. I had received a letter from my donor, a really touching, tear-jerking letter, my Transplant Coordinator, the one in a million Lucy, knew it would lift me right up. Lucy is one of the A-Team here at Portsmouth, and is honestly a ray of sunshine. She gets me, she knows the journey I’ve had, and is always pushing for the best for me. When I was in hospital I often sat by the window in my private room, watching the world go by, thankful for what I do have, thinking of those who have it far worse, that is

Stephanie's Uncle who donated to a stranger in turn for a stranger to give Stephanie a kidney

what keeps me from sinking, seeing the strength of others going through turbulent times. Now I’m home and 7 weeks post-transplant, in total I remained in hospital for 4 weeks. The team that got me here never thought my creatinine would be in the 200's never mind the 100's - it's currently 194 and my EGFR is 27 which is brilliant. They still hope the creatinine will drop further, but it will take some weeks for the kidney, named Frannie, to fully heal from all the treatment. I have the pd catheter and stent being removed in the next 2 weeks too. I feel OK in myself and am slowly processing it all.

HOLIDAY DIALYSIS IN NORFOLK Quiet, friendly, 2 bedded unit established 2011 Very experienced staff NHS funded Close to the beautiful Norfolk coast Covid precautions in place

TEL: 01485 545719 info@norfolkdialysis.co.uk www.norfolkholidaydialysis.co.uk

HELPLINE 0800 169 0936 | www.kidney.org.uk | Spring 2024 | 9

News & Events

Blood Pressure Medication High blood pressure is a very common condition but does not often cause symptoms. It is very important that it is controlled, otherwise this can result in further damage to your kidneys and also lead to other complications such as heart attacks and strokes. There are many tablets available to bring your blood pressure down. Different people respond better to different sorts. You should discuss with your doctor the type of tablet most suitable for you. A combination of a few tablets is often needed to have the effect wanted. You may not feel unwell with high blood pressure, but it is important to continue taking your tablets regularly. If you experience side effects, then you should speak to your doctor or renal team. The tablets listed below are ones commonly used. If you are taking a tablet not listed and would like more information then you can speak to your doctor or pharmacist.

Calcium Channel Blockers AMLODIPINE is usually taken once a day in the morning. Side effects can include headache, dizziness, and ankle swelling. NIFEDIPINE can be taken once or twice a day. You should avoid grapefruit and grapefruit juice for one hour before taking Nifedipine. Side effects can include headache, flushing and ankle swelling. Nifedipine comes as different forms of tablets, or capsules. Please follow the directions for the type given to you and always try to stick to the same brand. Other types of calcium channel blockers include FELODIPINE, DILTIAZEM, VERAPAMIL and LERCANIDIPINE.

Beta Blockers BISOPROLOL is usually taken once a day in the morning. Side effects can include tiredness and cold hands and feet. It is usually taken once a day. Other types of beta blockers include ATENOLOL and METOPROLOL.

Alpha Blockers DOXAZOSIN is taken once or twice a day. Side effects can include dizziness, headache, feeling sick. If this happens try taking with food. The long acting preparation (Cardura XL) is only taken once daily. Other types of alpha blockers include INDORAMIN and PRAZOSIN.

Ace Inhibitors LISINOPRIL, PERINDOPRIL and RAMIPRIL are usually taken once a day in the evening. Side affects can include tiredness and feeling sick. If this happens try taking with food. Sometimes you may get a dry cough, if this occurs, tell your doctor who may be able to consider an alternative for you. ACE Inhibitors are not safe in pregnancy.

Angiotensin Antagonists LOSARTAN is usually taken once daily. It is an alternative to an Ace inhibitor (see above) and the two should not be taken together. Side effects are usually mild but can include tiredness, dizziness and stomach upsets. Other types of angiotensin antagonist include valsartan, irbesartan and candesartan. Rarely, some people can get allergic reactions to angiotensin antagonists. This may include itching, a rash or swelling of the lips and face. If this happens you should stop taking your tablets and speak to your doctor. Angiotensin antagonists are not safe in pregnancy.

10 | Spring 2024 | www.kidney.org.uk | HELPLINE 0800 169 0936

Spring 2024

Diuretics/Water Tablets

Blood pressure medication and dialysis

Often high blood pressure in kidney disease is due to a build up of fluid. Taking a diuretic (water tablet) can sometimes lower your blood pressure by making you pee out some of this extra fluid. They are usually taken in the morning and sometimes a second dose may be needed at lunchtime.

Sometimes blood pressure medication can cause your blood pressure to fall too low during dialysis, causing problems. If this happens, the type of blood pressure medication you take may be changed or you may be advised to wait and take your medication after you have finished your dialysis session.

Examples of water tablets include:

You should store the tablets in their original packet in a cool, dry place out of the sight and reach of children.

FRUSEMIDE, BUMETANIDE and BENDROFLUMETHIAZIDE. Side effects include stomach upset and can upset water and salt levels in the blood leading to thirst, headache, low blood pressure and muscle cramps.

Other blood pressure tablets include: HYDRALAZINE is sometimes used when your blood pressure is still high after a combination of other tablets. Side effects can include fluid retention. ALISKERIN is a new drug that is sometimes used instead of ACE inhibitors or angiotensin antagonists. Side effects include an upset stomach and rash. MOXONIDINE is sometimes used when your blood pressure is still high after a combination of other tablets. Side effects can include tiredness, headache and dry mouth.

Do not throw out any expired or unwanted medicine by flushing them down the toilet or throwing them away. Take them to your local pharmacy.

Sick day guidance when you are unwell with: 1 Vomiting or diarrhoea 2 Fevers, sweats or shaking You should temporarily stop taking the following medications to reduce your chance of being admitted to hospital: • Diuretics – Bendroflumethiazide, furosemide, indapamide, spironolactone • ACE Inhibitors – Medicine names ending in 'pril' e.g. lisinopril, perindopril, ramipril • Angiotensin receptor blockers – Medicine names ending in 'sartan' e.g. candesartan, losartan, valsartan • Metformin – A medication used for diabetes • Non-steroidal anti-inflammatory pain killers, e.g. diclofenac, ibuprofen, naproxen You should restart any of the above medications that you have stopped when you are well. This is after 24-48 hours of eating and drinking normally. If you are unsure of whether to stop a medication, please contact your pharmacist, GP or specialist. Written by Charlotte Mallindine, Senior Renal Pharmacist

The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor or nurse.

Helpline 0800 169 09 36 The NKF Helpline is also the UK’s largest provider of kidneyrelated medical information leaflets with a library of over 200 titles written by nephrologists in simple language for patients and carers visit: www.kidney.org.uk/helpline-leaflets

HELPLINE 0800 169 0936 | www.kidney.org.uk | Spring 2024 | 11

News & Events

Anaemia and EPO by Kay Allardyce Kay Allardyce featured in our Winter 2023 Kidney Life issue with an extract from her published memoir, Thanks for My Kidney, Mum!, sharing her dilemma with social drinking and living with chronic kidney disease as a young adult. In this issue, Kay shares an extract from her book on her personal experiences with anaemia and EPO injections in the months leading up to receiving a transplant from her mother. Navigating the challenges of chronic kidney disease (CKD) was a significant part of my life. But in 2011, another layer of complexity was added to my health journey: severe anaemia. The fatigue was overwhelming, especially during my commutes to work in Tonbridge. I recall the perilous moments when I almost dozed off at the wheel, resorting to blasting the radio and opening the windows to keep myself awake. Even during my Pilates classes, I experienced episodes of feeling spaced out, a sensation that was hard to describe but undeniably alarming. Anaemia is a condition characterised by a reduced number of red blood cells or a reduced amount of haemoglobin in the blood. Haemoglobin is a protein in red blood cells that binds to oxygen, allowing these cells to transport oxygen from the lungs to the rest of the body. When someone has anaemia, their blood cannot carry enough oxygen to meet the body's needs, which can lead to symptoms like fatigue, weakness, pale or yellowish skin, shortness of breath, dizziness, and more. EPO (Erythropoietin) is a hormone produced primarily by the kidneys. It plays a crucial role in the production of red blood cells. When the body senses low oxygen levels in the blood (often due to anaemia), the kidneys produce and release more EPO. This hormone then stimulates the bone marrow to produce more red blood cells.

12 | Spring 2024 | www.kidney.org.uk | HELPLINE 0800 169 0936

In medical settings, a synthetic form of EPO is sometimes used to treat certain types of anaemia, especially in patients with chronic kidney disease or those undergoing chemotherapy. By administering EPO, doctors aim to stimulate the production of red blood cells and alleviate the symptoms of anaemia. However, like all treatments, EPO therapy has potential risks and benefits, and its use should be carefully monitored. Upon medical consultation, it was determined that my anaemia required erythropoietin (EPO) therapy and iron infusions. Damaged kidneys, like mine, produce less EPO, leading to fewer red blood cells and reduced oxygen transport throughout the body. This explained my episodes of altered concentration and fatigue. The treatment involved receiving an infusion of Venofer, an iron supplement. I vividly remember the experience at Guy’s Hospital, where the renal nurse administered the infusion via a vein in my elbow. The medication, thick and treacle-like, was slowly injected into my bloodstream. What was most startling was the unexpected liquorice taste that developed in my mouth mere seconds into the infusion. Despite the initial surprise, the aftermath of the treatment was invigorating. I felt rejuvenated, energetic, and ready to face the world.

In addition to the iron infusions, I was introduced to EPO therapy. The anaemia nurses trained me to self-administer the EPO at home using a medication called Mircera. The kit came with all the necessary sterile components, including clear visual instructions for assembling the needle and drug components. As someone who had incorporated acupuncture into my osteopathy practice, I was no stranger to needles. However, self-administration was a new experience. The first few times, I experimented with the injection site on my upper thigh, trying different techniques to minimise the sting. The discomfort was fleeting, lasting only a minute or so, and the benefits of the medication far outweighed the brief pain. This chapter of my life was a testament to the resilience and adaptability of the human spirit. Facing the challenges of CKD, recurrent cystitis, and now anaemia, I learned the importance of proactive healthcare, self-awareness, and the invaluable support of the medical community. Each treatment, each injection, was a step towards better health and a fuller life.

Kay with her Mum, Linda

In conclusion, my experience with anaemia and EPO injections was a journey of self-discovery, determination, and gratitude. It reinforced the importance of listening to one's body, seeking timely medical intervention, and the power of modern medicine.

Kay Allardyce is an osteopath and Pilates instructor who has written a book about her journey with kidney disease and undergoing a kidney transplant. You can buy the book from www.kosteo.co.uk. 'Thanks for My Kidney, Mum!' is £12.99 on paperback and £19.99 on hardback.

HELPLINE 0800 169 0936 | www.kidney.org.uk | Winter 2023 | 13

News & Events

Take Control of Your Health and Wellness

with NKF’s Helpline Information Leaflets The NKF Helpline information leaflets cover a wide range of topics such as chronic kidney disease, end-stage renal failure, emotional impact of CKD, and much more. The leaflets are free of charge and available in different languages for your convenience, they can also be mailed out free of charge upon request. Whether you're a patient, caregiver, or healthcare professional, our leaflets provide valuable information to help you better understand kidney disease.

Browse through our collection including information folders, dietary guidelines, exercise tips and benefits information, and more. We hope that these resources will serve as a helpful guide for you and those around you.

KIDNEY BASIC TITLES

HAEMODIALYSIS

KIDNEY DISEASE AND FOOTCARE

About the kidneys Chronic kidney disease How to cope with end stage renal failure I've got kidney disease The emotional impact of CKD End of life care for renal patients Conservative management for kidney disease Carer's information helping your loved one manage their renal condition (NEW 2024) Cholesterol and kidney disease Calculating kidney function High blood pressure Frequently asked questions about kidney disease Acute kidney injury Preventing AKI's Acidosis in patients with CKD Kidney biopsy Confronting depression while managing kidney disease

Introduction to haemodialysis Home dialysis the advantages Myth busting home dialysis Having a fistula for dialysis Living with a fistula for dialysis Fistula care Dialysis line insertion My first haemodialysis Fluid balance on dialysis Endoavf system more access options for your dialysis NKF Peer Support Booklet Peritoneal dialysis Introduction to peritoneal dialysis

Charcot feet Holiday feet Foot ulcers Footwear Exercise for kidney patients Exercise for kidney patients (NEW Nov 2023) NKF and Leicester kidney lifestyle team Staying fit with kidney disease Let's get active – exercise for kidney patients Can I safely exercise with high blood pressure

KIDNEY DISEASES AND CONDITIONS Anaemia Iron deficiency anaemia and CKD Glomerulonephritis Q and A Haematuria Kidney cysts Pain in kidney and urine disease 12 Steps towards pain control Protenuria Small or single kidney Diabetes and kidney disease Focal and Segmental Glomerulonephritis (FSG) IGA Nephropathy IGM Nephropathy What is Vasculitis Henoch- Schonlein Purpura ARPKD Adult polycystic kidney disease Renal artery stenosis Amyloid Kidney disease in myeloma MPGN Membrano Proliferative Glomerulonephritis Minimal change nephropathy Nephrotic syndrome in adults Loin pain haematuria Interstitial nephritis Urinary infections Reflux Alport's syndrome Lupus and lupus kidney disease Fabry disease Bones, calcium, phosphates & PTH Kidney failure Good mouth care for renal patients Calciphylaxis

DRUGS Medication for immunosuppression and prevention of infections in kidney patients Commonly taken drugs for kidney failure Over the counter drugs Blood pressure medication Holiday travel vaccinations in transplant patients TRANSPLANTATION SERIES Top tips information about transplants What is a kidney transplant How long does the kidney transplant operation take How are kidneys allocated The transplant phone call – what to expect The transplant procedure – what to expect How long is the wait for a kidney transplant Is a kidney transplant psychologically stressful Complications of a transplant Can a transplant come from a relative, partner or friend Are work and normal life possible after transplant What drugs are needed after transplant Infection after transplant Diabetes after transplant Blood pressure, cholesterol, heart disease after transplant What is transplant rejection After my transplant- what to expect Skin care in renal transplant patients Sexual problems following a transplant Cancer after a transplant LIVING DONOR INFORMATION Living donor information How do kidney donors feel afterwards Reimbursement of living donor expenses by the NHS Going home after donating a kidney

14 | Spring 2024 | www.kidney.org.uk | HELPLINE 0800 169 0936

HOLIDAY INFORMATION FOR KIDNEY PATIENTS Holiday tips and guidelines Holiday guidelines for pd patients Holiday guidelines for hd patients Holiday guidelines for transplant patients DIETARY INFORMATION Potassium The eatwell plate Can kidney patients eat fruit and vegetables Dietary information for kidney patients (CKD 4-5) Healthy eating for people with chronic kidney disease (CKD 1-3) Phosphate in your diet INFORMATION FOLDERS/BOOKLETS Benefit guide for kidney patients 2023 Dietary information folder CKD stage 3 information folder Dialysis information folder Exercise information folder Post transplant information folder Pre- transplant information folder NKF new patients support book

For more information on our NKF Helpline information leaflets, please visit our website: www.kidney.org.uk/helpline-leaflets Our free to call confidential Helpline is available on: 0800 169 09 36 Available from: Mon-Thurs: 08:30am – 5:00pm, Fri: 08:30am – 12:30pm Or alternatively email: helpline@kidney.org.uk

Combine top quality dialysis treatment with amazing holidays, on the island of Rhodes Dialysis Centre is a state-of-the-art dialysis unit, located within the Euromedica General Clinic of Rhodes, in Greece, that complies with European standards of health and safety while providing quality dialysis services in a modern setting. The centre is located just 10 minutes from Rhodes town, 4Km from the resort of Kallithea and 9Km from the popular resort of Faliraki.

We accept the European Health Insurance Card (EHIC)

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16/10/23 2:33 PM

News & Events Your Stories

The

Greatest Gift

Jane with her three sons

Jane Colebrook’s story is of hope, resilience and the power of a second chance. Jane’s life was turned upside down when she discovered she had kidney failure. Emergency dialysis and a failed transplant followed. However, a second chance came in the form of a successful transplant and a new lease of life. With a loving husband, three healthy sons, and a beautiful granddaughter, Jane’s transplant has lasted over 34 years, giving her the greatest gift of all – a happy life. Kidney failure reared its unpleasant head in my 21st year, I was unable to donate blood due to being anaemic. Whilst doctors were finding the cause of my anaemia, I celebrated Christmas 1984 and the new year becoming engaged to my future husband Tim. At the end of February, I suffered a fit due to sudden total kidney failure and was admitted to Addenbrooke's Hospital. I underwent an operation for a fistula so that I could go on the dialysis machines which were at Douglas House, on Trumpington Road in those days. Dialysis left me washed out and I went on the transplant list immediately. I married Tim in August 1985 and was called in for transplant three weeks later. It was unsuccessful. I was very ill afterwards and dialysis on the machines was becoming unpleasant. As soon as I could, I went onto CAPD and was able to lead a normal life.

I used to change bags sunbathing on the beach or riding the motorways in Tim's lorry. On 27th September 1989 I had my second transplant; nine days later I walked out of hospital. Life was fun again and my body was functioning properly. It was functioning so well our first son, Peter, was born 12th January 1991. It was a lovely pregnancy with no problems although senior doctors kept their eyes on me. I managed to shock everyone by having another son, William within twelve months and again no problems. I loved having our boys and we led a very happy family life and check-ups at the kidney clinic became further apart. February 5th 1995 saw our third son, Joe, arrive into the world. He was the first to go to full term, the other two being 7 and 5 weeks early. Our family was complete. By the late nineties I was going to clinic every 6 months. As I grew older the high steroid dose began to affect my bones. In the last ten years I have had to have surgery on my thumb joint and a knee replacement. I have been very lucky as I was warned my blood group, AB negative was difficult for transplant, plus I had a lot of antibodies after my first failed transplant. My transplant has lasted over 34 years. Although showing signs of coming to an end, it has given me the greatest gift of a happy life, a wonderful family and 2 years ago a beautiful granddaughter, Daisy. Jane with granddaughter Daisy and husband Tim

16 | Spring 2024 | www.kidney.org.uk | HELPLINE 0800 169 0936

MY KIDNEY JOURNEY

is a website designed to provide information to help you live a full life with kidney disease. Wherever you are on your kidney journey, high quality information is always useful. It helps you to feel confident and get the best from time with your healthcare team.

Welcome to My Kidney Journey It has lots of helpful, practical information about:

Treatment options Coping with emotions

Diet, exercise and other lifestyle choices

Causes, stages and symptoms of kidney disease

Information for carers and loved ones

WHY NOT VISIT MY KIDNEY JOURNEY TODAY? https://mykidneyjourney.baxterhealthcare.co.uk/ Because the more you know, the easier it is to make choices that are right for you. Adverse Events should be reported. For the UK reporting forms and information can be found at www.mhra.gov.uk/yellowcard. For Ireland report to the Health Products Regulatory Authority (HPRA) using a Yellow Card obtained from the HPRA via the online system (www.hpra.ie) or by telephone on +353 (0)1-6764971. Adverse Events relating to Baxter products can also be reported direct to Baxter Pharmacovigilance on +44 (0)1635 206360, or by email to vigilanceuk@baxter.com

UKI-RC00-220080 V1.0 October 2022

News & Events Your Stories

Finding a Kidney Donor and Friend

My name is Chetan and my kidney journey began back in 2004. During a routine hospital appointment I had following a very debilitating stroke I had the previous year, it was discovered that I had early-stage renal failure. At 32 years old and learning that I had another illness to contend with following the near-fatal stroke, seemed very unfair to me. My speech was severely affected, as was my mobility, job and personal life (I was also going through a divorce at the time). I had no symptoms of renal failure, I accepted the news and carried on rebuilding my life as best as I could.

In the morning, I was rushed back to hospital where I had a blood test. The results returned and I was rushed to Hammersmith Hospital where I stayed for a week. I was given various drugs to stop the fever and I got better over the following days. I had an infection caused by staphylococcus bacteria that had entered my line. The doctor told me that I was lucky to be alive.

During the years that followed, I couldn’t understand why I was being told that my renal function was declining as I generally felt fine. My speech and mobility issues were a thing of the past as life returned to a state of normality. Around 2012 I was told to begin to consider which method of dialysis I wanted to proceed with as my kidney function was around 15%. I was still in denial as I felt fine and attended a friend’s wedding overseas that December. Upon my return home, I was told that I had to begin dialysis within the next couple of weeks. In April of 2013, I had the procedure to have the line fitted and I attended my first dialysis session the following day at a unit. A month later, I was transferred to the dialysis unit at my local hospital and was slowly getting into the routine of managing going to work and dialysis treatment. One Friday evening, during dialysis, I began to shiver. This didn’t bother me at first. When the dialysis session ended around midnight, I returned home as normal. The shivering got worse, I put on a jumper but I began to sweat profusely. I tried to get to sleep but my pillow had become soaked and I was feeling so hot and also had the shivers. I couldn’t understand what was happening to me. Chetan Joshi and his donor Jean Short 18 | Spring 2024 | www.kidney.org.uk | HELPLINE 0800 169 0936

Spring 2024

I was transferred back to my local hospital for a few traumatic days after which I was able to go home. Upon my return home, I was told that I had been made redundant from work. This came as another blow but I felt lucky to be alive so took it on the chin. I felt this was a moment to join my local KPA, the West London Kidney Patients’ Association. I joined the KPA and offered to put my graphic design and web skills to use. I was tasked with rebranding the charity as well as redesigning the website and newsletter which I continue to do today. Over the following weeks, it was arranged for me to undergo a fistula procedure and have my line removed. I welcomed this as I was assured that fistulas presented with fewer chances of infections. Life with a fistula was much better but wasn’t without complications. The nurses would often struggle to find a vein and I became very despondent as I would return home with my arm bruised and scarred. Coupled with the fact that I had no job, life was grinding me down.

You can find more about my account in the Autumn 2019 edition of the WLKPA newsletter: https://www.westlondonkpa.org/newsletters-2019 Actively involving West London in renal health issues and care Registered Charity 275771

The West London Kidney Patients’ Association

Newsletter “Hello… This is your kidney donor” The unforgettable day I met my kidney donor

Autumn 2019 Contents Page 1-3

“Hello…This is your kidney donor.” The unforgettable day I met my kidney donor

Page 4

Bill Duffy Darts Fundraiser Annual memorial event In Memoriam Helen Philomena Russell 1949 – 2019

Page 5

BACCES Cheque Presentation

Written by Chetan Joshi – WLKPA – Photo: Visit to Kew Gardens – Aug ‘19

Page 6-7

Team Hammersmith

How we did at the British After receiving my kidney transplant in August 2015 Transplant Games from a living, non-related kidney donor, their identity Page 8-9 remained a mystery to me. All I really knew was that Organ Donation and Islam & the new Verdict she was an elderly lady, about my mum’s age. Over the Page 10 years since, we have been able to communicate with 1st UK black living kidney appreciation event each other by sending greeting cards and letters via our Page 11 hospitals. (I affectionately call her “My Angel.”) However, Hilary’s Story this system broke down earlier this year when I grew Dates for your diary Page 12-13 concerned that I hadn’t received a Christmas card from Dietary Feature her as I had previously done. I inquired at the hospital if Page 14 there was any way to find out if my donor was ok. I was NKF Annual Patient Event 2019 naturally concerned for her well being. It was suggested Page 15 that it could be arranged for the two of us to exchange Coffee Break Puzzle contact details so we could contact each other directly Page 16 without the hospitals’ intervention. Continued on page 2 ➤ Summer Day Trips 2019

In March 2015 I received an unexpected call from the renal unit manager. This call was a turning point for me. She said that a stranger had come forward and wanted to donate their kidney and I was the best match for them. I couldn’t believe what I was hearing. To cut a very long story shorter, now eight years on, I am delighted with my kidney transplant. My kidney donor, Jean has become a great friend to me and we chat regularly on a weekly basis, we try to visit each other throughout the year too. We’re both big fans of Strictly Come Dancing and have a good chat about what’s going on and discussing contestants, analysing dances, putting the world right, etc. We have a special bond that I feel truly blessed to have.

My kidney donor, Jean has become a great friend to me and we chat on a weekly basis, we try to visit each other throughout the year too. We have a special bond that I feel truly blessed to have.

HELPLINE 0800 169 0936 | www.kidney.org.uk | Spring 2024 | 19

Fundraising News & Events

THE 2023 CHRISTMAS DRAW

The 2023 Christmas Draw took place on Tuesday 12th December 2023 and the winners are... 1st Prize £1,500 - J. Burr ticket number 059480 2nd Prize £750 - M. Thomas ticket number 061977 3rd prize £500 - KG & E Hodkinson ticket number 040207 4th Prize £125 - L. Mouser ticket number 025205 5th Prize £125 - J. Sklaroff ticket number 006717 A big congratulations to all! Also, a BIG THANK YOU goes out to all that took part. Without your support, we wouldn't be able to do all the amazing things we do to help patients and families affected by kidney disease.

NKF SPRING DRAW This spring you could win one of four cash prizes including a first prize of £1,000 by taking part in our spring draw. Tickets are enclosed in this edition of Kidney Life or you can purchase them online at: www.kidney.org.uk/shop What would you do with the cash?

DO SOMETHING SPECIAL IN 2024

Here at the NKF we offer a great array of events to take part in, please visit the NKF events page www.kidney.org.uk/Pages/Events. You will see we have skydives, wing walking, inflatable fun, and running events from around the UK and Europe, plus overseas treks. Each event has a registration fee that you pay and then the rest of the costs are covered by sponsorship from friends and family. If you would like to talk about and events or fundraising in general please email pete@kidney.org.uk or call 01263 722287.

SPOTLIGHT ON TWO OF OUR EVENTS

Ben Nevis Trek July 5th 2024 This exciting challenge has been achieved in the past by dialysis and transplanted patients, it will see you conquering Ben Nevis, the highest mountain in the UK. We'll begin our adventure in the heart of the breath-taking Western Highlands of Scotland at Fort William. The mountain attracts many trekkers, climbers and mountaineers as the 700-metre-high cliffs of the north face are among the highest in the United Kingdom and are one of the principal locations for ice climbing. The trail to the summit is not technically difficult, but trekking will be strenuous; stamina and determination are a must. The stunning views of the highlands will be with you all the way and provide a fantastic backdrop to this epic weekend adventure. Don your boots and let's get trekking!

For more details please visit: www.kidney.org.uk/Event/ben-nevis-trek-2024 20 | Spring 2024 | www.kidney.org.uk | HELPLINE 0800 169 0936

Spring 2024

Inflatable 5k Fun Around the UK The world’s largest and best Inflatable event is coming in 2024

The 2024 edition of the Inflatable obstacle course has gotten Bigger, Bouncier and Better! Choose one of six locations around the UK for a fun-packed 5K, check out the video to see what it looks like https://youtu.be/3WssMpTWVOE dates are below and for more details please visit www.kidney.org.uk/Event/inflatable-events

Inflatable 5K Events 2024: DONNINGTON PARK, Derby – 13th April WOLVERHAMPTON – 22nd June SOUTHAMPTON – 20th July

TATTON (WA14 3QA) – 3rd August NEWBURY – 28th September NORWICH – 12th October

HELPLINE 0800 169 0936 | www.kidney.org.uk | Spring 2024 | 21

News &Time Puzzle Events

PUZZLES

If you’ve got a few minutes to spare, put your feet up and have a go at our puzzle!

WORDSEARCH

This issue’s wordsearch contains some ‘Spring’ related words. Even though at the time of going to press, it definitley doesn't feel like Spring! Have fun and good luck!

RAINBOW PRUNING FLORAL DUCKLING HATCHING DAISIES BLOSSOM GRASS DAFFODIL CALF LAMB SUN ALLERGIES NESTING CHIRPING BEEHIVE SEEDS RAINCOAT PASTEL BULBS

HOLIDAY DIALYSIS CARE IN THE LAKES!

Look forward to a great holiday in the stunning Lake District whilst letting Lakeland Dialysis cater for all your haemodialysis needs in a relaxed and professional atmosphere. WHERE ARE WE? Situated on the Northwest edge of the Lake District National Park, adjacent to the Cumbrian market town of Cockermouth we have been specialists in holiday dialysis since 2004. Things to do include taking in the majestic fell views, visiting the steam railway, cruising on a lake or just relaxing and enjoying the rich and local hospitality on offer.

QUALITY CARE Regulated by the CQC we pride ourselves in offering: personal and professional care, individual appointment times, disabled parking facilities and ground floor access.

TREATMENT COSTS ARE COVERED BY THE NHS BOOKING WITH US For more information, please speak with your Renal Team, contact us on 01900 822 888, e-mail info@lakelanddialysis.co.uk or visit our website www.lakelanddialysis.co.uk where you can make a booking enquiry, as well as access lists of locally available LakelandDialysisinCockermouth accommodation recommended by previous visitors to the clinic.

Lakeland Dialysis Ltd, Unit 7E, Lakeland Business Park, Lamplugh Road, Cockermouth, Cumbria, CA13 0QT

www.lakelanddialysis.co.uk

22 | Spring 2024 | www.kidney.org.uk | HELPLINE 0800 169 0936

WE NEED YOUR SUPPORT MORE THAN EVER BEFORE

Your donations help us to make a difference to others! The National Kidney Federation (NKF) relies entirely on your support and donations to continue its vital work supporting kidney patients and their families. Your regular donations will help support every kidney patient in the UK £20

Helps us with printing and postage costs to distribute our free of charge Helpline leaflets

£10

Helps towards our campaign to increase patients on home dialysis

£5

Helps us make Government changes in Parliament

£2

Covers the cost of your Kidney Life magazine

WAYS TO DONATE Donate by PHONE

Donate ONLINE

You can call us on 0800 169 0936 for a chat and to make a donation.

Or visit https://www.kidney.org.uk/ Appeal/donate

Donate I wish to make a donation to the NKF by: One-off card payment by POST I would like to donate a one-off

regular monthly

payment of: £5

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£10

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My name:

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Address:

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NB: Please complete in all cases

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Card No:

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Direct Debit Instructions (NB: please complete your name / address in the above boxes) Name of Account holder:

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*Cheques payable to: National Kidney Federation

Please send to: National Kidney Federation

The Point, Coach Road, Shireoaks, Worksop, S81 8BW

If you are a UK taxpayer your donation will be worth 25% more at no extra cost to you. Yes – I am a UK taxpayer and would like to Gift Aid my donations now and in future. I understand I must pay enough income tax and/or capital gains tax each tax year to cover the amount of Gift Aid that all charities and community amateur sports clubs claim on my donations in that tax year, and I am responsible for paying any difference. I will inform you if my tax status, name or address change or if I wish to cancel my Gift Aid declaration.

Charity Nos. 1106735 SC049431 Company No. 5272349 Registered in England & Wales

Office Ref No. HELPLINE 0800 169 0936 | www.kidney.org.uk | Winter 2022 | 23

ENTER OUR SPRING PRIZE DRAW

The draw takes place on Wednesday 8th May 2024, please send your tickets and cheques back to us by Friday 3rd May 2024. If you would like more draw tickets purchase your tickets online www.kidney.org.uk/shop/nkf-spring-draw or scan the QR code.

YOU COULD WIN £1,000!